Our Summary

This research paper looks at the effects of delaying surgery for patients with chronic sciatica, a condition which causes pain down the back of the leg, due to a herniated disc in the lower spine. A group of patients with this condition were split into two groups: one group had an operation to remove the herniated disc soon after being diagnosed, while the other group tried non-surgical treatment methods for six months before considering surgery.

The results showed that the group who had surgery sooner experienced less leg pain six months after surgery compared to the group who delayed surgery. Other health and wellness scores also favored the early surgery group. The rate of complications from surgery was similar in both groups.

In conclusion, this research suggests that for patients with chronic sciatica due to a herniated disc, having surgery sooner rather than later leads to better outcomes in terms of pain and disability.

FAQs

  1. Does having surgery sooner rather than later lead to better outcomes for patients with chronic sciatica due to a herniated disc?
  2. Are there more complications from surgery for patients who delay surgery for chronic sciatica?
  3. Does the level of leg pain differ between patients who have early surgery and those who delay surgery for chronic sciatica?

Doctor’s Tip

A helpful tip a doctor might tell a patient about microdiscectomy is to consider having the surgery sooner rather than delaying it, as research shows that early surgery leads to better outcomes in terms of pain relief and overall function.

Suitable For

Patients who are typically recommended microdiscectomy are those who have chronic sciatica due to a herniated disc in the lower spine. These patients may have tried non-surgical treatment methods without success and are experiencing significant pain and disability as a result of their condition. Additionally, patients who have neurological symptoms such as weakness or loss of sensation in the legs may also be good candidates for microdiscectomy. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if microdiscectomy is the right course of action for them.

Timeline

Timeline before and after microdiscectomy:

Before surgery:

  1. Patient experiences chronic sciatica symptoms, such as pain down the back of the leg, numbness, and weakness.
  2. Patient undergoes diagnostic tests, such as MRI or CT scan, to confirm a herniated disc in the lower spine.
  3. Patient tries non-surgical treatments, such as physical therapy, pain medication, and epidural steroid injections, for a period of time to manage symptoms.
  4. If symptoms do not improve or worsen, patient and healthcare provider discuss the option of microdiscectomy surgery.

After surgery:

  1. Patient undergoes microdiscectomy surgery to remove the herniated disc, typically performed under general anesthesia.
  2. Patient may stay in the hospital for a day or two for monitoring and pain management.
  3. Patient starts physical therapy and rehabilitation to regain strength and mobility in the affected area.
  4. Patient gradually resumes normal activities and work, with restrictions on lifting and bending for a period of time.
  5. Patient follows up with healthcare provider for post-operative care and monitoring of symptoms.
  6. Over time, patient experiences relief from leg pain, numbness, and weakness, and improves overall function and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about microdiscectomy include:

  1. What are the potential risks and complications associated with microdiscectomy surgery?
  2. What is the success rate of microdiscectomy in terms of relieving pain and improving function?
  3. How long is the recovery period after microdiscectomy surgery?
  4. What alternative treatment options are available for my condition, and how do they compare to microdiscectomy?
  5. How will my daily activities be affected after the surgery, and when can I expect to return to work and normal activities?
  6. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?
  7. What are the chances of the herniated disc reoccurring after microdiscectomy surgery?
  8. How long do the benefits of microdiscectomy typically last?
  9. Are there any long-term effects or complications associated with microdiscectomy surgery?
  10. How experienced is the surgical team in performing microdiscectomy procedures, and what is their success rate?

Reference

Authors: Bailey CS, Glennie A, Rasoulinejad P, Kanawati A, Taylor D, Sequeira K, Miller T, Watson J, Rosedale R, Bailey SI, Gurr KR, Siddiqi F, Urquhart JC. Journal: Global Spine J. 2023 Sep;13(7):1856-1864. doi: 10.1177/21925682211054040. Epub 2021 Nov 3. PMID: 34732096